County approves care-home reforms

Jacob forecasts ‘silver tsunami,’ says overhaul needed

San Diego County officials launched an effort to protect residents of assisted living centers on Tuesday, increasing oversight staff, focusing prosecutions and partnering to offer more site-specific information for consumers.

County supervisors agreed to double the staff in their Long-Term Care Ombudsman program, to eight full-time positions, reversing cuts approved five years ago.

They also began work with the Better Business Bureau to create a rating system for assisted living homes so families will have more confidence in the decisions they make for their elderly relatives.

District Attorney Bonnie Dumanis announced a pilot project dedicated to prosecuting crimes inside assisted living homes — neglect and abuse incidents that regularly go unpunished by state investigators.

“While many assisted living homes and skilled nursing facilities do right by our elderly, others are a source of shame,” Supervisor Dianne Jacob said in announcing the series of local reforms. “Watchdog reports in U-T San Diego and other media outlets have documented deeply disturbing gaps in treatment and supervision at some facilities that have led to serious illness and even death. The conditions at some homes are deplorable.”

The U-T’s “Deadly Neglect” series in September and December, a partnership with the CHCF Center for Health Reporting, identified at least 27 deaths due to abuse or neglect at local assisted living homes in recent years.

Deadly Neglect

Scores of other residents were sickened by medication errors and other deficiencies, the reports showed, and the state police force charged with investigating crimes inside the homes has not made an arrest since 2004.

Under California law, the heftiest state fine regulators can impose is $150, even when a resident is killed as a result of a violation.

County supervisors also voted to support the RCFE Reform Act of 2014, a series of bills introduced in January by bipartisan lawmakers incensed at findings in the U-T and other media outlets. RCFE is the state acronym for the homes, known as residential care facilities for the elderly.

Among other things, the reform bills would boost fines for violations, require more frequent inspections of homes, speed up the time it takes to investigate complaints and require licensees to buy liability insurance.

The bills are making their way through the statehouse, with a key set of hearings set for early next month.

Meanwhile, the county board action on Tuesday directs top administrators to work with home operators and the Better Business Bureau to develop a grading system that rates specific homes based on past compliance with state regulations.

A budget and update on that project is due by the end of this year.

Dumanis introduced a program aimed at prosecuting abuse and neglect cases from inside senior homes, and a media campaign to raise awareness of abuse and neglect issues.

The effort begins with $190,000 in current-year sales-tax revenue earmarked for public safety projects. In July, $1.3 million of those funds will help prosecutors boost enforcement of standards of care and improve their review and follow-up work on incident reports and criminal referrals.